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Axillary lymph node dissection in triple-negative or HER2-positive breast cancer patients with clinical N2 achieving pathological complete response after neoadjuvant therapy: Is it necessary?

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作者：
Guo Xuhui[1] * ; Zhang Jiao[1] ; Gong Xilong[1] ; Wang Jia[1] ; Dai Hao[1] ; Jiao Dechuang[1] ; Ling Rui[2] ; Zhao Yi[3] ; Yang Hongjian[4] ; Liu Yunjiang[5] ; Liu Ke[6] ; Zhang Jianguo[7] ; Mao Dahua[8] ; He Jianjun[9] ; Yu Zhigang[10] ; Liu Yinhua[11] ; Fu Peifen[12] ; Wang Jiandong[13] ; Jiang Hongchuan[14] ; Zhao Zuowei[15] ; Tian Xingsong[16] ; Cao Zhongwei[17] ; Wu Kejin[18] ; Song Ailin[19] ; Jin Feng[20] ; Fan Zhimin[21] ; Liu Zhenzhen[1] ;
机构： [1]Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Dongming Road, Zhengzhou, Henan Province, 450008, China. [2]Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China. [3]Surgical Oncology Department, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110022, China. [4]Department of Breast Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, 310022, China. [5]Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 052360, China. [6]Fourth Department of Breast Surgery, Jilin Cancer Hospital. Changchun, Jilin Province, 130012, China. [7]Department of Breast Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, 150086, China. [8]Department of Breast Surgery, Affiliated Wudang Hospital of Guizhou Medical University, Guiyang, Guizhou Province, 550009, China. [9]Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061, China. [10]Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, 250033, China. [11]Breast Disease Center, Peking University First Hospital, Beijing, 100034, China. [12]Department of Breast Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China. [13]Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, 100852, China. [14]Department of Breast Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China. [15]Department of Breast Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, 116023, China. [16]Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, 250021, China. [17]Department of Thyroid, Breast, Hernia Surgery, The Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia Autonomous Region, 010017, China. [18]Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200433, China. [19]Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu Province, 730000, China. [20]Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning Province, 110002, China. [21]Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China.
出处：
DOI： 10.1016/j.breast.2024.103671
ISSN：

摘要：
This study aims to identify suitable candidates for axillary sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) among clinical N2 (cN2) triple-negative (TN) or HER2 positive (HER2+）breast cancer patients following neoadjuvant therapy（NAT）.Despite the substantial axillary burden in cN2 breast cancer patients, high pathological response rates can be achieved with NAT in TN or HER2+ subtypes, thus enabling potential downstaging of axillary surgery.A retrospective analysis was conducted on data from the CSBrS-012 study, screening 709 patients with initial cN2, either HER2+ or TN subtype, from January 1, 2010 to December 31, 2020. The correlation between axillary pathologic complete response (pCR) (yPN0) and breast pCR was examined.Among the 177 cN2 patients who achieved breast pCR through NAT, 138 (78.0 %) also achieved axillary pCR. However, in the 532 initial clinical N2 patients who did not achieve breast pCR, residual axillary lymph node metastasis persisted in 77.4 % (412/532) of cases. The relative risk of residual axillary lymph node metastasis in patients who did not achieve breast pCR was 12.4 (8.1-19.1), compared to those who did achieve breast pCR, P < 0.001.For cN2 TN or HER2+ breast cancer patients who achieve breast pCR following NAT, consideration could be given to downstaging and performing an axillary SLNB or TAD.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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外文
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中科院分区：
出版当年[2025]版：
大类 | 2 区 医学
小类 | 2 区 妇产科学 2 区 肿瘤学
最新[2025]版：
大类 | 2 区 医学
小类 | 2 区 妇产科学 2 区 肿瘤学
JCR分区：
出版当年[2024]版：
Q1 OBSTETRICS & GYNECOLOGY Q1 ONCOLOGY
最新[2024]版：
Q1 OBSTETRICS & GYNECOLOGY Q1 ONCOLOGY

影响因子： 最新[2024版] 最新五年平均 出版当年[2024版] 出版当年五年平均 出版前一年[2023版]

第一作者：
第一作者机构： [1]Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Dongming Road, Zhengzhou, Henan Province, 450008, China.
通讯作者：
推荐引用方式(GB/T 7714)：
Guo Xuhui,Zhang Jiao,Gong Xilong,et al.Axillary lymph node dissection in triple-negative or HER2-positive breast cancer patients with clinical N2 achieving pathological complete response after neoadjuvant therapy: Is it necessary?[J].BREAST.2024,73:103671.doi:10.1016/j.breast.2024.103671.
APA：
Guo Xuhui,Zhang Jiao,Gong Xilong,Wang Jia,Dai Hao...&Liu Zhenzhen.(2024).Axillary lymph node dissection in triple-negative or HER2-positive breast cancer patients with clinical N2 achieving pathological complete response after neoadjuvant therapy: Is it necessary?.BREAST,73,
MLA：
Guo Xuhui,et al."Axillary lymph node dissection in triple-negative or HER2-positive breast cancer patients with clinical N2 achieving pathological complete response after neoadjuvant therapy: Is it necessary?".BREAST 73.(2024):103671

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